Microbes in the Environment
"[The] ability to inactivate microbes in the environment on a continuous basis is important because bacteria, including MRSA, can survive in a variety of conditions for long periods of time and can spread via dust particles, clothing, furniture, or hospital equipment that have been in contact with infected patients..."
Dr. Charles P. Gerba PhD
Professor of Environmental Microbiology
University of Arizona
By KaiScience Staff
Virtually all communities in North America have regular and ongoing restaurant inspections by local public health department officials. The goals of these inspections are to identify potential risk factors that could cause illnesses for patrons and to evaluate how well these problem areas are addressed and rectified. Reports of these inspections are usually kept on record, and together they present a snapshot of current conditions and past trends in a community's eating establishments when it comes to hygiene and cleanliness.
In one study, from 1996 through 2000, in 31 counties in the U.S. state of Oklahoma, more than 4,000 inspections of "medium-risk" and "high-risk" establishments were analyzed to determine rates of critical violations along with repeat violations. It was found that repeat violations accounted for about half of all violations. And those establishments that had already been designated high risk were found to have higher violation rates than those termed moderate risk - meaning the violations were more serious and more frequent in the high-risk restaurants.
In all but the largest county in the state, Oklahoma County, chain restaurants were found to be significantly more likely than other restaurants to have recurrent violations of critical items, usually related to food holding temperatures, hygiene practices, sanitization, and the cleanliness and hygiene of the facilities.
Violations among nonchain establishments were most often caused by poor hygienic conditions and cleaning practices. Although a variety of factors are involved here, what is apparent - at least when it comes to cleaning, maintenance, and hygiene - is that many restaurant facilities simply have no way of knowing if recently cleaned surface areas, such as floor tile and grout, are truly free of germs and other contaminants. And many restaurants use older, conventional cleaning systems that may, in reality, do little to actually remove and eliminate these surface-level contaminants, making it difficult for them to keep their facilities clean.
Testing for Cleanliness
In most situations, we do not test a surface's cleanliness after it has been professionally cleaned. However, in restaurants, food service, as well as health care and other industries, the need for some type of measurement system is becoming increasingly obvious. At one time, the only way to measure whether an area was thoroughly clean was to collect samples and place them in Petri dishes, allowing any bacteria and other contaminants present to grow. This procedure would reveal the number of microbes present; however, it was slow and time consuming. In the 1970s, microorganism detection devices were developed. These machines can rapidly evaluate the presence of microorganisms on a variety of surfaces, from utensils and cutlery to floors and walls, according to Martin Easter, general manager of Hygienia International, which manufactures rapid hygiene-monitoring systems, environmental collection systems, and other devices used to determine the presence of microorganisms on surfaces and instruments.
Some of these devices look for the presence of adenosine triphosphate (ATP), which is a molecule found in all living cells and often called "the energy currency of life." If ATP is found on a surface, "it provides a risk assessment, indicating there is a possibility it may host microorganisms, and that organic matter capable of supporting the life of germs is present," says Easter. "And this can be potentially harmful to human health."
To test for the presence of ATP on a typical surface, the area is swabbed and the swab is placed in the testing equipment. The device will determine if ATP is present and in what amount. "If ATP is there, it will glow," says Easter. "The glow is analyzed by the monitoring equipment, which provides a number corresponding to relative light units (RLU). The higher the RLU, the more ATP, the greater the possible risk, and the greater the need for more thorough and effective cleaning of the surface area tested."
The system can also be used as a simple way to demonstrate cleaning effectiveness. Testing before cleaning will provide the necessary feedback to determine if ATP is present. Testing again after cleaning lets you know if the ATP has been effectively removed. Thresholds can be set, depending on the surface, to give the user a "pass," "caution," or "fail" result.
The early-model detection systems were rather large and expensive, but over the years they have gotten much smaller - some are handheld - less expensive, easier to use, and much more precise, which makes their use in the restaurant industry much more viable. And with some equipment, Easter says, the results of the test can be determined in less than a minute, which is why some systems are referred to as "rapid" monitoring devices.
Cleaning to Remove Contaminants
One of the problems many restaurants and large, more industrial-style food service facilities have is that they typically use quarry tile floors in their kitchens. These floors are very hearty and durable, but they are porous, as is the grout used to secure the tiles to the floor. These porous surfaces can become home to different forms of microorganisms.
Although mopping with chemical solutions and water can clean the surface level of these floors, the mop - whether a conventional string mop or even a microfiber one - usually cannot clean deep into the pores. Recent studies by a variety of independent scientists have borne this out. Cleaning is more difficult in the grout areas because they are below the surface of the floor, making them hard to reach. The cleaning alternative to mops that some food service facilities find useful in deep-cleaning these floors is to pressure-wash them with a spray-and-vac cleaning system. These systems apply a cleaning chemical, Green or conventional, to all surfaces to be cleaned. The surfaces are then rinsed clean with water at as much as 500 psi (pounds per square inch), enough pressure to loosen deeply embedded soils and contaminants. Completing the process, the water and contaminants are then extracted using the machine's built-in wet/vac.
Another contamination concern is counter surfaces, foodhandling work stations, even dining room tables. Recently, new flat surface cleaning (FSC) systems have been developed that appear to be more effective at cleaning these areas because they minimize the use of cleaning cloths. Studies indicate that cleaning cloths quickly lose their effectiveness at removing contaminants and can actually spread germs as they are used. With FSC systems, a motorized sprayer unit applies chemicals and disinfectants directly on a microfiber pad that is used to clean the surface. The same area is then wiped dry with a squeegee, which removes contaminants and soils and dries the surface. (See sidebar for other restaurant uses.)
Beyond High Tech: The Importance of Cleaning
Although we now have high-tech systems available to test for cleanliness as well as new cleaning equipment and technologies to deep-clean surface areas - both helping to reduce the spread of infection - nothing can be accomplished without realizing the importance of a cleaning and maintenance program that keeps eating establishments clean and healthy. According to one building service contractor, at one time many restaurants and food service facilities hired a professional cleaning crew to clean restaurant and food service kitchens on a nightly basis. However, because of cost concerns, many establishments turned this task over to kitchen attendants, who often have little formal training in cleaning, do not like doing the job, and do not realize the importance of the task. This is likely one reason why so many restaurants in the study mentioned earlier failed to pass health inspections and were repeat offenders. But if food establishments are to turn things around, pass health inspections, and help protect the health of their customers, training and the proper equipment and tools are mandatory.
Sidebar:
The Quick Wipe May Be Asking for Trouble
A new trend has been developing in the restaurant business. Over the past several years, a number of restaurants have chosen not to place tablecloths on their dining room tables. A bare tabletop is part of their "design statement" and creates the atmosphere and ambiance they are looking for. However, this might not be the most hygienic policy for patrons. A bare wood, Formica, or similar tabletop can get very grimy - and germ ridden - during the course of the evening. In some restaurants, a bleach and water solution is used to clean table tops but even then it is "hit and miss" with most tabletops wiped down quickly with plain water and a used (likely soiled) cleaning cloth. No cleaners or sanitizers are applied and the goal is simply to get the table ready for the next set of guests as soon as possible. But during the course of the evening, people may sneeze on the table, food particulates are deposited, used forks and knives are left on the table, and patrons' hands touch the surface. As any epidemiologist will tell you, we catch other people's illnesses more frequently through skin contact - touching soiled surfaces - than through sneezing or even kissing. So a hardly wiped, bare tabletop is a festering point for germs. Because of this, some restaurants are also using FSC (flat surface cleaning) systems to more thoroughly clean and disinfect tabletops. Many find it is as fast and easy as the "quick wipe" traditionally applied and considerably more sanitary and hygienic.
Reference:
Margaret L. Phillips, Brenda L. Elledge, Heather G. Basara, Robert A. Lynch, and Daniel T. Boatright. "Recurrent Critical Violations of the Food Code in Retail Food Service Establishments." Journal of Environmental Health 68 (June 2006), no. 10: 2430.
Popular Topics: MRSA | Staph | Norovirus | Flu | E. Coli | C. Difficile | Salmonella | Cleaning for Health | Nosocomial Infections | Disinfection | Bacteria | Viruses | Indoor Air Quality | Asthma | Allergies | Allergen | Mold
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